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McKesson Clinical Reference Systems: Women's Health Advisor 2002.2
Illustration
Ovarian Cysts
What are ovarian cysts?
Ovarian cysts are fluid-filled sacs in or on an ovary.
Women normally have two ovaries. They are the female organs
that hold and release eggs. They also produce the female
hormones estrogen and progesterone.
Ovarian cysts are common and occur in two types: functional
and abnormal. Functional cysts develop as a part of the
normal functions of an ovary. Usually they are smaller than
abnormal cysts and they go away without treatment.
How do they occur?
The most common functional cysts are follicular and corpus
luteum cysts:
- A follicular cyst forms when the egg-producing follicle
of the ovary gets bigger and fills with fluid.
- A corpus luteum cyst occurs after an egg has been
released from the follicle. If pregnancy does not occur,
the corpus luteum usually disintegrates. However,
occasionally it swells with fluid or blood and remains on
the surface of the ovary as a cyst.
The most common abnormal cysts are dermoid cysts. These
cysts are similar to skin tissue on the outside and are
filled with fatty material and sometimes bits of bone, hair,
and cartilage.
What are the symptoms?
Ovarian cysts often cause no symptoms at all. If symptoms
occur, they may be:
- abdominal pain or indigestion
- pain during sexual intercourse
- changes in menstruation such as heavy periods, painful
periods, or no periods
- a firm, painless swelling in the lower abdomen
- a feeling of pressure or fullness in the abdomen or
pelvis
- irregular bowel or bladder function
- an increase in facial and body hair.
If the cyst becomes twisted, it usually causes severe
abdominal pain, nausea, and vomiting.
How are they diagnosed?
Ovarian cysts may be diagnosed with tests and exams, such
as:
- a medical history
- a physical exam
- a pelvic ultrasound exam
- an abdominal CT scan (computed tomography)
- MRI (magnetic resonance imaging)
- an x-ray of the urinary system.
Ovarian cysts are sometimes hard to diagnose. It is not
always clear whether the mass that the health care provider
feels during an exam is attached to the ovary or to some
other organ, is stool in the rectum, or is merely a full
bladder. Ultrasound is frequently helpful in confirming the
diagnosis and measuring the size of the cyst. Abnormal
cysts are usually 5 cm or larger.
How are they treated?
Functional ovarian cysts are common and seldom require any
treatment. Taking birth control pills may make them go
away. They may also disappear in a few months without any
treatment. Functional cysts that don't go away can
sometimes be drained.
Cysts 5 cm or larger that don't go away usually have to be
removed with surgery. Smaller abnormal cysts also may have
to be removed. Often a cyst can be removed without damaging
the ovary. But sometimes the only way to ensure complete
removal of the cyst is to take out the entire ovary and
possibly the fallopian tube as well. Because you have two
ovaries and two fallopian tubes, you may still be able to
get pregnant if only one tube and one ovary are removed.
Certain types of cysts can reappear, sometimes as cancer.
For this reason, if you have completed your family or are
past menopause, your health care provider may advise surgery
to remove both ovaries and the uterus.
Often one of the following surgeries is done:
- Laparoscopy: Your abdomen is filled with a gas, and tiny
incisions are made for a laparoscope (a thin metal tube
with a light and tiny camera) to enter the abdomen. The
surgeon uses the laparoscope to look for a cyst. The
doctor may take a sample of fluid with a syringe. The
sample is then sent to the lab for microscopic studies to
check for cancer. The surgeon may then do a laparotomy
if the cyst is cancerous. (Ninety-five percent of cysts
are not cancerous.)
- Laparotomy: An incision is made through the abdomen so
the doctor can remove the cyst. The cyst is sent to the
lab for tests.
How long will the effects last?
Many ovarian cysts cause no noticeable symptoms and are
found only during a regular pelvic exam or by ultrasound.
It is important for you to have regular checkups so that if
you have an ovarian cyst and there is any chance of the cyst
rupturing, the cyst can be removed before it ruptures. A
ruptured cyst can be very painful and dangerous, especially
if it is filled with blood.
What can be done to help prevent ovarian cysts?
Because the causes of ovarian cysts are unknown, the best
prevention is to:
- See your health care provider if you have any symptoms.
- Have a pelvic exam and Pap smear as often as your health
care provider recommends.
If you tend to have ovarian cysts often, your provider may
recommend that you take birth control pills to help stop the
cysts from coming back.
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